In Memoriam - Dr Jay Grosfeld

Sad news disseminated quickly last October through the medical community: Professor Jay Grosfeld has died at age 81. The news had a profound impact upon the pediatric surgery community literally all over the world, as he was considered a giant and a founding father in the field.

Under these circumstances, many journals around the world considered writing an editorial about the work and the life of Dr. Grosfeld. For me was a moral duty to write one. I knew some things about Jay Grosfeld, but I started to search more information about him from papers or interviews and I have to confess that I remained charmed by his life, as well as his personality. It was not a barren work writing this editorial, but a very captivating one.

Every exposure about a great personality presumes some biographical data. Professor Grosfeld was born in New York City in 1935. He graduated from the New York School of Medicine in 1961, and then he started a residency in Surgery in the same city. He continued with a residency in Pediatric Surgery at Ohio State University College of Medicine, Columbus, OH, which he graduated in 1970. During that time, he was a Fellow in the American Cancer Society, Senior Clinical Traineeship. He began his career in Pediatric Surgery and between 1970 and 1972, Jay Grosfeld was an Assistant Professor of Surgery and Pediatrics at New York University. In 1972 he left New York City and followed his medical path in a different city, Indianapolis, IN. Over time, he became Professor and Director of Pediatric Surgery at Indiana University School of Medicine and Surgeon-in-Chief at James Whitcomb Riley Hospital for Children. Dr. Grosfeld was also Professor and Chairman in the Department of Surgery, at Indiana University School of Medicine.

He was guided to medicine by his mother and one of his uncles. Medicine was not a tradition in his family, but he wanted to open new doors. Family was always a strong support for him, a landmark for his formation, a loving, supportive and educational place. A good education sometimes presumes rigid rules, but is certainly a key for future successes. I imagine that Prof. Grosfeld was such a personality, that whatever he was to do and anywhere he was to go, he would have become very successful. Many areas of medicine fascinated him, but he endeared Surgery and Pediatrics, hence the decision to become a Pediatric Surgeon.

His long journey started at Columbus University, Ohio. He worked in the team led by Dr. Clatworthy, who had a profound contribution on his development. Dr. Clatworthy was the kind of person who could have a profound impact on many aspects of one’s personal and professional development: critical thinking, clinical skills, research conducting and scientific paper writting. The seed was launched and helped to produce a great harvest. Grosfeld had to leave Ohio and a temporary medical station was New York. His professor there was Frank Spencer, another giant in Pediatric Surgery, who also marked his personality. Spencer continued to nurture Grosfeld`s personality and his medical development. It was not for a long time though, as Grosfeld had to leave New York. As his family expanded (by that time he already had five children), he took the decision to move to a different place. That location was going to be the place in which he would become well-known all over the world: Indianapolis.

Riley Children`s Hospital from Indianapolis was an ordinary hospital before Dr. Grosfeld’s coming, where a small number of operations were performed on a regular basis. He exponentially increased the number of operations, as he performed new and pioneering operations. A great turning point was the reconsideration of the clinic work. The careful monitoring of patients day by day and round and round was one of his great achievements. He could work with abnegation many hours per day, with very little sleep. As a leader, one has to be an example for everybody in the team. One has to formulate questions and find the best solutions, particularly for those clinical cases that are not going well. Prof. Grosfeld put the basis of collaborative work with other surgeons, pediatricians and administrative staff, in order to dispose a wider clinical view and more resources for his patients. He was also the catalyzer for the development of different surgical subspecialties. Numerous residents and junior surgeons trained under his leadership, of which many eventually became great surgeons around the world. He traveled the world to disseminate his new concepts in Pediatric Surgery.

Jay Grosfeld dedicated significant time to research work. In Indianapolis, he put the basis of a new laboratory, virtually from scratch. He obtained grant funding for equipment and for an animal facility, which resulted in numerous animal studies. He tackled the most difficult unresolved medical problems, such as certain types of pediatric malignancies (hepatoblastoma, neuroblastoma), congenital malformations, short bowel syndrome, necrotizing enterocolitis, obesity, tissue ischemia and transplantation. He was especially dedicated to newborn pathology, which is the most difficult, as babies cannot express themselves. However, he had remarkable results, keeping in mind that those were the days where the usual quote amongst the neonatologists was “don`t let the surgeons touch the baby”. Dr. Grosfelt brought new concepts in trauma: quick interventions in some cases and a non-interventional “wait-and-watch” approach in others. I believe there is no important chapter of pediatric surgery, where Prof. Grosfeld had no contributions. He published numerous papers to disseminate his research. His name remained connected to the most respected journal in the field, “Journal of Pediatric Surgery”, where he functioned as editor-in-chief until his death.

Jay Grosfeld enjoyed being a teacher, as well. He definitely wanted to share his knowledge with his students, residents, fellows and junior faculty physicians. He always discussed medical problems, whether in large or small groups, in the hallways or in the operating rooms, standing by the children. He educated them how to formulate questions, how to solve them, how to “to read the baby” and simply how to be a good surgeon, the techniques and tactics in pediatric surgery.He brought the doctor closer to the patient and the family. Prof. Grosfeld had a tremendous success, being a traditional doctor and teacher, based on clinical experience, not only on digital support or high-tech equipment. He wrote many textbooks and chapters that now are regarded as “the bible” in pediatric surgery.

Prof. Grosfeld was Chairman of the Surgical Section of the American Academy of Pediatrics, President of the American Paediatric Surgical Association, Chairman of the American Board of Surgery, President of World Federation of Association of Paediatric Surgeons (WOPAS) and First vice- President of the American College of Surgeons. He received the William E Ladd Medal from American Academy of Paediatrics, the Sir Denis Browne Gold Medal, from British Association of Paediatric Surgeons and Fritz Rhebein Medal from European Association of Paediatric Surgeons. Prof. Grosfeld was Honorary Fellow of many surgical colleges around the world. His statue now stands at the entrance to the Riley Hospital for Children in Indianapolis, IN, a modest memento for a life dedicated to the well-being of children.

Unfortunately, I have never met Prof. Grosfeld in person, although now, after reading so much about him, I feel like I have... However, from the discussions I had with people who had the pleasure of knowing him, I understand that he was known as a friendly and kind person. He had a large family, including a loving wife of a lifetime, five children and seventeen grandchildren. He was very proud of his family and this was also an important part of his legacy. I know of at least two of his grandsons who are preparing for medical school, with the intention of becoming pediatric surgeons: life goes on!

Jay Grosfeld remains a giant in medicine, especially in the pediatric surgical community. Whether as a medical doctor, researcher or a teacher, he was a role model. He saved and improved the lives of many children in America, as well as around the world.He will live through the saved children, his disciples and his wonderful family. I conclude with the Grosfeld`s father phrase that traced his entire career: “you go to work every day and do the best job you can do and things will work out for you”.